Members Members Residents Job Board
Join Today Renew Your Membership Make A Donation
1998 Abstract: ILEAL ABSORPTIVE ADAPTATION TO JEJUNAL RESECTION AND EXTRINSIC DENERVATION: IMPLICATIONS FOR LIVING RELATED SMALL BOWEL TRANSPLANTATION. GG Tsiotos, K Bierens, J Duenes, MG Sarr. Dept. of Surg., Mayo Clinic, Rochester, MN. 78

Abstracts
1998 Digestive Disease Week

#982

ILEAL ABSORPTIVE ADAPTATION TO JEJUNAL RESECTION AND EXTRINSIC DENERVATION: IMPLICATIONS FOR LIVING RELATED SMALL BOWEL TRANSPLANTATION. GG Tsiotos, K Bierens, J Duenes, MG Sarr. Dept. of Surg., Mayo Clinic, Rochester, MN.

Previously we showed decreased ileal absorption of water, electrolytes, bile salts, and glutamine after a canine model of jejunoileal autotransplantation (DDS 41:1915, 1996). AIM: To determine the role of extrinsic innervation in the ileal absorptive adaptation to jejunal resection. METHODS: 10 dogs were studied before, 2, and 12 wk after proximal 50% enterectomy without (CON, n=5) or with extrinsic denervation (EXT DEN, n=5) by a model of autotransplantation of the remaining ileum. Using a double-lumen perfusion technique, absorption of electrolytes and 5 simple nutrients (table) was measured at these 3 time points. RESULTS: All dogs developed diarrhea postop which resolved by 6 to 12 wk in all CON dogs but persisted in 2 of 5 EXT DEN dogs. Weight in both groups was decreased at 2 wk (p<0.05), remained low in EXT DEN (p<0.05), but normalized in CON dogs. Maximal weight loss was greater in EXT DEN (p<0.05). Intragroup analysis (paired t-tests) showed no consistent or important differences in absorption of electrolytes or simple nutrients among CON or in EXT DEN. Intergroup analysis at each time point showed no difference in absorption between groups.

 

CON

EXT DEN

 

Before

2 wk

12 wk

Before

2 wk

12 wk

    Sodium

33 ± 6

41 ± 7

42 ± 10

35 ± 3

34 ± 3

29 ± 3*

    Potassium

16 ± 8

29 ± 8

31 ± 8*

23 ± 4

23 ± 4

16 ± 3

    Chloride

37 ± 7

45 ± 8

46 ± 11

39 ± 3

40 ± 3

34 ± 3*

    Arginine

61 ± 6

67 ± 2

63 ± 7

64 ± 3

60 ± 4

54 ± 7

    Glutamine

58 ± 5

67 ± 3

66 ± 5

67 ± 2

62 ± 5

68 ± 6

    Glucose

71 ± 3

70 ± 2

69 ± 9

71 ± 3

65 ± 4

61 ± 4

    Taurocholic cholate

70 ± 5

63 ± 9

68 ± 8

64 ± 4

53 ± 9

50 ± 13

    Oleic acid

35 ± 11

39 ± 11

50 ± 10

47 ± 6

37 ± 6

35 ± 8

 ± SEM % absorption, n = 5/group; *differs from before, p < 0.05; no differences noted between groups at any time point.

SUMMARY: Extrinsic denervation of ileum results in persistent weight loss after proximal 50% enterectomy. Despite diarrhea, only minor changes in electrolyte absorption occur, and ileal absorption of simple nutrients remains unaffected. CONCLUSIONS: The extrinsic denervation necessitated by small bowel transplantation does not appear to influence the ileal absorptive adaptive response to jejunal resection.

Support NIH RO1 DK39337 [MGS].

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.



Society for Surgery of the Alimentary Tract

Facebook Twitter YouTube

Email SSAT Email SSAT
500 Cummings Center, Suite 4400, Beverly, MA 01915 500 Cummings Center
Suite 4400
Beverly, MA 01915
+1 978-927-8330 +1 978-927-8330
+1 978-524-0498 +1 978-524-0498
Links
About
Membership
Publications
Newsletters
Annual Meeting
Join SSAT
Job Board
Make a Pledge
Event Calendar
Awards